Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XM0800X | Mental Health |
NPI | 1255818118 |
---|---|
Provider Name | Ms. Sakiyna Mozell Peets |
First Address | Charlotte, NC 28216-5804 |
Second Address | Charlotte, NC 28216-5804 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2018 |
Last Update Date | 24/07/2018 |